Embrace: a population based Integrated Elderly Care model showed improved results and saves costs

Wynia, Klaske; Kremer, Bph; Spoorenberg, S.S.; Uittenbroek, RJ; Reijneveld, S.A.

doi:10.1093/eurpub/cku164.021

Cited by 2 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The initiatives reviewed here included both newly established care systems that adopted the population health approach from the start and established acute care systems that have developed elements of integrated population health-based systems in more recent times. Many of these initiatives were established in response to increasing rates of chronic diseases and multimorbidity thus addressed the needs of high-need/high-cost populations [912333435], and some have begun to combine these efforts with population health management [123637].…”

Section: Resultsmentioning

confidence: 99%

“…Redesigning care delivery often included efforts to segment and stratify populations based on risk/needs profiles. These profiles were formulated based on complexity of medical conditions [333454], diseases and population demographics [333456], costs 25, 27] or their combination [25505357]. The types of care offered to population segments were transformed and included elements such as mechanisms for the coordination of care [93350515458], referrals [3645485459], case management [3334364353], follow-ups [36436061] and team-based care [333436435050] to help address specific needs of the population segments.…”

Section: Resultsmentioning

confidence: 99%

“…Evaluations concentrated on the impact of integrated care on utilization outcomes such as admissions to hospitals, visits to emergency rooms, hospital length of stay and outpatient visits [912334648536370]. The majority of initiatives that reported before and after comparisons of utilization impacts of the interventions reported statistically significant benefits for the access to care and services, including same day appointments [3441497071]; reductions in wait time for referrals [3570]; reductions in emergency room use, hospital admissions and 30-day readmissions, and length of stay [947485357]; increased uptake of screening and immunizations [474861]; reductions in overall morbidity and mortality rates [475359], and overall quality of care [951]. Two randomized controlled trials (RCT) were included [1233].…”

Section: Resultsmentioning

confidence: 99%

“…Efforts to embed the population health approach within integrated care face a number of challenges. Initiatives reviewed here reported difficulties with population segmentation and the planning of needs-based services [333439], difficulties with funding mechanisms and models of care that can accommodate the interactions of multidisciplinary teams [3357], challenges with hierarchical management, governance and accountability of integrated care systems [953], and with adapting traditional evaluation strategies to assess the complexities of integrated population health-based type of care [94144]. The crucial role of the “integrator” as well as the need for creativity and innovation with the use of funding and programming [394160687180] are often key to shifting traditional care to integrated and population health-based systems of care.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Combining Integration of Care and a Population Health Approach: A Scoping Review of Redesign Strategies and Interventions, and their Impact

Farmanova¹,

Baker²,

Cohen

2019

International Journal of Integrated Care

View full text Add to dashboard Cite

Background and aim: Many health systems attempt to develop integrated and population health-oriented systems of care, but knowledge of strategies and interventions to support this effort is lacking. We aimed to identify specific redesign strategies and interventions, and to present evidence of their effectiveness. Method: A modified scoping review process was carried out. Fifteen relevant examples of integrated care organizations that incorporated a broad population health approach in countries of the Organization for Economic Cooperation and Development described in 57 articles and reports were included in analysis. Results: Seven key redesign strategies and multiple redesign interventions have been identified and are described. Most commonly used redesign strategies included focusing on health and wellness, embracing intersectoral action and partnerships, addressing health in vulnerable groups, and addressing a wide range of determinants of health, including making improvements in health services. Redesign interventions included creative and innovative ways of addressing clinical and non-clinical issues such as establishing housing surgeries in primary care, establlishing vast social and provider networks to support patients with complex needs and also broadening of the scope of services, workforce redesign and other. Potential reductions in the utilization of care and costs could be derived by the wider adoption of these strategies and interventions. Conclusion: Development of integrated and population health-oriented systems of care requires the redesign of how services are organized and delivered, and how organizations and care systems operate. Combining integration of care with the population health approach can be supported by a set of cohesive strategies and interventions aimed at preventing disease, addressing social determinants of health and improving health equity at both population- and individual-level.

show abstract